Riabtsev R. Individualization of surgical treatment of duodenal injuries and its consequences

Based on clinical and instrumental research and statistical analysis of the dissertation of Ryabtsev RS "Individualization of surgical treatment of duodenal injuries and its consequences" identified scientific and theoretical provisions, which together allowed to theoretically generalize and identify new ways to solve the current problem of surgical treatment of patients with duodenal injuries. Scientific data on identifying the most significant criteria for rapid mortality prediction in patients with duodenal injury have been supplemented, and a new mathematical prediction model has been developed to divide patients into risk groups for hospital admission with an overall accuracy of 96.7%. An improved diagnostic algorithm revealed that multiple intra-abdominal injuries and injuries of the structures of the retroperitoneal space were in 72.2% of victims, most of whom were in a severe and extremely serious condition on admission to the hospital. Studies on the role of endothelial dysfunction in the development of systemic complications in the early stages of traumatic illness have been further developed. The studies established the compliance of the marker of gastrointestinal damage I-FABP for the distribution of patients with complications and living, with a limit of 648 pkg / ml at a sensitivity of 0.875 and a specificity of 0.857. The scientific data on the principles of staged surgical tactics in different categories of victims with priority application of minimally invasive technologies, primary suture of the duodenum and new methods of its exclusion in repeated surgical interventions are specified, the treatment algorithm with proven clinical effectiveness is developed. Scientific data have been supplemented and the main directions in the treatment of postoperative complications have been identified, and the contribution of each of them to the development of adverse effects has been scientifically proven.